Let's learn about Tick-Borne Relapsing Fever (TBRF)

Imagine that you have a high fever for a few days. Then the fever goes away on its own. You think you're okay. But about a week later, for no apparent reason, you have a high fever again. This kind of fever comes and goes... Isn't it a bit strange? This is the main symptom of Tick-Borne Relapsing Fever (TBRF) . This is not a very common disease, but it is very important to be aware of it.

How does this disease develop?

Simply put, this disease is caused by a type of bacteria . This bacteria enters our bodies through the bite of a special type of tick . We call these ticks 'soft ticks'.

Unlike the hard ticks we are familiar with, these soft ticks do not stay attached to our bodies for days. They suck blood within a short period of time, about 15 to 30 minutes, and then go back to where they came from. The most important thing is that when these ticks bite, we do not feel any pain. So sometimes we do not even know if we have been bitten by a tick.

These ticks live in the nests of small animals like mice and squirrels. That's why this disease is especially associated with rustic cabins in mountainous areas. Because in such places, animals like mice build nests inside the walls and roofs. At night, when we sleep, the ticks in these nests come out and suck our blood.

Although this disease is not commonly reported in Sri Lanka, it is very important to be aware of this if you are traveling to mountainous areas in foreign countries, especially in countries like the United States, Canada, and Mexico.

What are the symptoms of this?

It usually takes about a week for symptoms to appear after a tick bite. The main symptom is, as I mentioned earlier, a high fever that comes and goes.

At the end of each fever episode, your body temperature may suddenly rise to a very high level (perhaps as high as 106.7 F). This may last for about 10-30 minutes. Then the fever suddenly drops, and you may sweat profusely.

In addition to this main symptom, several other symptoms can be seen.

How is the diagnosis made?

If you are showing these symptoms, your doctor will first examine you carefully. He or she will also ask about recent travel, especially to mountainous areas and old wooden houses where these soft ticks can live.

To confirm the diagnosis, a sample of your blood is taken. This blood sample is usually taken when you have a fever. In the laboratory, a scientist examines a small sample of your blood under a microscope. This will show you exactly whether the bacteria that cause the disease, called *Borrelia*, are present in your blood. Under a microscope, these bacteria look like a small corkscrew.

What are the treatments?

Most of the time, this disease can be cured without treatment. However, if the disease is confirmed, the doctor will prescribe antibiotics . These kill the bacteria that cause the disease. The most commonly used drugs are tetracycline and doxycycline. Pregnant women and young children are usually given another type of antibiotic , such as erythromycin. Most people feel better within a few days of starting the medication.

Something special to remember!

Here's something special to know: More than half of people who receive treatment may experience a temporary increase in symptoms (high fever, chills) within the first few hours after starting antibiotics.

Most of the time, these symptoms will go away on their own within a few hours. Your doctor may ask you to stay in the hospital for observation for the first few hours after starting the medication. Very rarely, some people may experience difficulty breathing. If this happens, it is important to seek medical advice or go to the Emergency Department (ETU) immediately.

Can complications occur?

With the right antibiotic treatment, this infection will clear up completely within a few days. Complications are rare.

However, in rare cases, TBRF can damage the nerves that connect your eyes or ears. This can cause hearing or vision loss. It can also cause a temporary paralysis of the facial muscles, called Bell's palsy . In rare cases, inflammation of the heart can occur.

If you contract this disease during pregnancy, the risk of complications such as premature birth or low birth weight may be slightly increased. Therefore, a pregnant mother should be especially careful about this.

How can you protect yourself from this disease?

The best thing to do is to avoid being bitten by ticks.

• If you are going to an area where ticks are likely to be present, use bug repellent when outdoors. You can use a liquid containing permethrin on clothing, or a product containing DEET on skin and clothing.
• If you are staying in an old wooden resort, check for rodents. Check for things like bee colonies. If you see any, get rid of the rodents and their nests with the help of a pest control professional.

Fever, Ticks, TBRF, Relapsing Fever, Borrelia, Treatment, Symptoms, Infections